Patients’ Expectations in a Geriatric Rehabilitation Ward: Matching with Actual Outcomes

Abstract

Aim: Person-centered care is a core issue in rehabilitation; the study aims at: 1) enquiring the outcome expectations of patients in a geriatric rehabilitation ward; 2) matching outcome expectations with actual outcomes. Methods: Expectations of 186 patients [79.4 (8.7) years, 70% females] analyzed through a questionnaire. 80.6% of patients were discharged home; functional recovery = 17.7 (22) points in Barthel Index total score, and 5 (4.2) points in Barthel Index walking subscore; also conditions with nursing needs improved significantly. Results: Patients’ expectations were coded as: functional (31.4%), overall (29.6%), and clinical improvement (21.5%), discharge home (7%); no answers or explicit lack of expectations (7.5%). Walking ability recovery differed according to outcome expectations. Highest improvements were achieved by patients wishing clinical improvement, followed by those expecting functional or overall improvement (5 points) [p = 0.009 (Welch)/p = 0.041 (Brown- Forsythe)]; worst improvement in walking ability (2.8 points) were got by patients faulting or declaring explicit failure of expectations. Conditions with nursing needs improved most in those expecting clinical improvements [p = 0.029 (Brown-Forsythe)], and less in case of expectation default. No further matching was found. Conclusions: Improvement in actual outcomes matched expected improvements in two circumstances: recovery in walking ability and in conditions with nursing needs. The high yield of different favorable outcomes may have masked the statistical significance for correspondence between actual and expected results. Special attention is worthy towards patients short of expectations, as their actual outcomes result poorer.